Background: Toxic epidermal necrolysis (TEN) is an uncommon but life-threatening adverse drug reaction. Pemetrexed is a multitargeted antifolate. It was first used in combination with cisplatin as a front-line treatment for malignant pleural mesothelioma. The same combination is nowadays approved in the first-line setting for locally advanced or metastatic nonsquamous non-small cell lung cancer (NSCLC). Patient and Methods: We report the case of a 50-year-old man treated for metastatic NSCLC. Within 5 days after administration of the second cycle of cisplatin and pemetrexed, he developed large blisters, which secondarily became hemorrhagic, and mucosal lesions. The characteristic clinical appearance, the histopathological findings, and the clinical course were decisive for the diagnosis of TEN. Treatment with systemic steroids and intravenous antibiotics as well as topical wound treatment led to resolution and improvement of his general condition. Conclusions: To the best of our knowledge, this is the third case of TEN due to pemetrexed in a patient with NSCLC. Clinicians should be aware of TEN as a rare but potentially fatal disorder requiring hospitalization and multidisciplinary management.

Zusammenfassung Patienten mit neurologisch bedingten Leistungsdefiziten, deren Teilhabe am Arbeitsleben nicht ausgeschlossen ist, ben?tigen eine m?glichst erfolgreiche berufsbezogene Rehabilitationsstrategie. Im Auftrag der Deutschen Rentenversicherung wurde daher ein intensiviertes, berufsbezogenes Behandlungskonzept entwickelt, das sich an den beruflichen Rahmenbedingungen orientiert.